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Oral Session 20 – Lung cancer studies

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O20.1 OCCUPATIONAL RISKS IN THE POPULATION BASED CASE–CONTROL STUDY, GENETIC EPIDEMIOLOGY OF LUNG CANCER AND SMOKING (GELCS)

D. Consonni1, P. A. Bertazzi1, A. C. Pesatori1, A. Colombi1, E. Bramati1, M. Corno1, M. Rubagotti1, B. Marinelli1, B. Albetti1, M. Bonzini1, S. Giacomini1, C. Mensi1, N. Caporaso2, M. T. Landi2.1Department of Occupational Health, Istituti Clinici di Perfezionamento and University of Milan, Milan, Italy; 2Division of Cancer Epidemiology and Genetics, NCI/NIH/DHHS, Bethesda, MD, USA

Introduction: A population based case–control study (Genetic Epidemiology of Lung Cancer and Smoking; GELCS) is being conducted in Lombardy, northern Italy. The research is sponsored by the NCI in the USA, and has the participation of 13 large hospitals. The aim is to enrol 2000 incident cases and 2000 randomly selected population controls (frequency matched to cases by area, sex, amd age quinquennia) in the study period April 2002 to early 2005. Pathological biospecimens are collected from cases, and a blood sample (or a buccal rinse) from all the participants; through a computer assisted personal interview and a self administered questionnaire, detailed information is recorded on numerous risk factors, including smoking and occupational history (jobs held for 6+ months). We performed preliminary analyses of occupational lung cancer risks on a sample of 721 subjects (389 cases and 332 controls, 82% and 77% males, respectively) selected for proteomics analyses.

Methods: Jobs were first coded according to international classifications of industry and occupations (ISIC 71, ISCO 68), and then, following a standardised method, classified as known (List A) or suspected (List B) lung carcinogens where applicable. We used unconditional logistic regression to compute odds ratios (ORs) and 95% confidence intervals (95% CI) adjusted for area, age, cigarette smoking (pack years, as a continuous variable, and its square), and years since quitting smoking.

Results: Only six women had worked in List A (2) or B (4) jobs. Among males, 29 cases (9.7%) and 12 controls (4.4%) reported having ever worked in List A jobs (OR 2.07, 95% CI 0.90 to 4.75): the excess was due to jobs in non-ferrous metal basic industries (12 cases and six controls; OR 2.40, 95% CI 0.66 to 8.76) and painters (15 cases and five controls; OR 1.85, 95% CI 0.59 to 5.76); no elevated risk (OR 0.94) was found for List B jobs (64 cases and 54 controls).

Conclusions: Occupations with known carcinogenic potential were found to double the risk of lung cancer; the corresponding aetiological fraction was 5%.

O20.2 RISK OF CANCER DUE TO OCCUPATIONAL EXPOSURE TO SIX TYPES OF CHLORINATED HYDROCARBONS

H. Richardson1, K. Aronson1, J. Siemiatycki2.1Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen’s University, Kingston, ON, Canada; 2Department of Preventive and Social Medicine, Université de Montréal, Montréal, QC, Canada

Introduction: We report on the association between 11 sites of cancer and six specific chlorinated hydrocarbons that have been used frequently as industrial solvents: carbon tetrachloride, chloroform, methylene chloride, 1,1,1-trichloroethane, trichloroethylene, and perchloroethylene.

Methods: From 1979 to 1986, eligible cases comprising all incident (male) cases of the following sites were identified: stomach (n = 251), colon (n = 340), rectosigmoid (n = 234) and rectum (n = 191), liver (n = 48), pancreas (n = 116), lung (n = 857), prostate (n = 449), bladder (n = 484), kidney (n = 177), and “lymphomas” (Hodgkin’s, non-Hodgkin’s and myeloma combined for this analysis; n = 292). A random sample (n = 533) was selected from the Montréal area electoral lists to serve as population controls. A detailed description of each job as well as potential confounders was collected in an interview. Trained chemists reviewed each job description and inferred possible chemical exposures. Multivariable logistic regression methods were used to estimate disease exposure odds ratios.

Results: An increased risk for prostate cancer was observed among men who were exposed to substantial levels of perchloroethylene (odds ratio 5.79, 95% confidence interval 1.12 to 30.02), and was suggestive for chloroform (4.81; 0.29 to 79.95). Substantial exposure to carbon tetrachloride or perchloroethylene appears to increase risk of lung cancer (2.19; 0.78 to 108.9, and 6.26; 0.97 to 40.28, respectively). Suggestive associations were seen between liver cancer and substantial exposure to 1,1,1-trichloroethane (3.02; 0.31 to 29.92), trichloroethylene (2.76; 0.29 to 25.95), or perchloroethylene (3.47; 0.12 to 100.34). When occupations associated with these chemicals were evaluated in separate models, results include elevated risk for prostate cancer among nurses and therapists (2.80; 0.45 to 17.49), who are often exposed to chloroform.

Conclusions: These results reflect potential cancer risks in occupations with exposure to chlorinated hydrocarbons, and may be considered as noteworthy hypotheses for further investigation.

O20.3 RISK OF LUNG CANCER FROM EXPOSURE TO DUSTS AND FIBRES IN RUSSIA

A. Baccarelli1,2, M. Tretiakova3, S. Gorbanev4, A. Lomtev4, I. Klimkina4, V. Tchibissov5, O. Averkina5 , C. Rice6, M. Dosemeci1.1Division of Cancer Epidemiology and Genetics, NCI/NIH/DHHS, Bethesda, MD, USA; 2Department of Occupational Health, University of Milan, Milan, Italy; 3Department of Pathology, University of Chicago, Chicago, IL, USA; 4Center of Hygiene and Sanitation, St. Petersburg, Russia; 5Pathological Bureau, St. Petersburg, Russia; 6Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA

Introduction: Several dusts and fibres have been established or suggested as human lung carcinogens. We conducted an autopsy based case–control study in the Leningrad Province, Russia to investigate the association of lung cancer risk with exposure to 58 different dusts and fibres.

Methods: We identified 540 pathologically diagnosed lung cancer cases (474 males, 66 females) and 582 controls (453 males, 129 females) among subjects who died in the hospitals of the Leningrad Province between 1993–1998. We retrieved subject specific quantitative measurements performed since the 1920s of 15 organic, 15 manmade, and 28 natural inorganic dusts and fibres in each work facility of the study area. We used unconditional logistic regression to compute sex specific odds ratios (ORs) and 95% confidence interavals (CIs) for lung cancer adjusted for age, smoking, and residence.

Results: Nearly 90% of the study subjects had been exposed to one or more of the 58 dusts and fibres evaluated. The average exposure intensity was higher than maximum allowable concentration (MAC) in 16% of the subjects. Among men, lung cancer risk was increased in workers exposed to linen dust (OR 3.68; 95% CI 1.00 to 13.6) or unspecified dusts and fibres (1.44; 1.07 to 1.94). A moderate, non-significant excess risk, correlated with exposure intensity, was observed in men exposed to manmade vitreous fibres (1.82; 0.88 to 3.75). Male subjects exposed to quartz dust had an OR of 1.27 (0.83 to 1.93). In female subjects, a small non-significant excess risk, which tended to increase with cumulative exposure, was observed for paper dust (1.77; 0.74 to 4.20), and unspecified dusts and fibres (1.52; 0.77 to 3.03).

Conclusions: In this study, based on extensive exposure information covering a wide time period, most study subjects were exposed to dusts and fibres, often above the maximum allowable concentrations. We observed increased lung cancer risks for specific categories of dusts and fibres.

O20.4 COOKING FUMES AND LUNG CANCER RISK AMONG CHINESE WOMEN IN HONG KONG

Y. L. Chiu, I. T. S. Yu.Department of Community and Family Medicine, The Chinese University of Hong Kong, Hong Kong, China

Introduction: Chinese women have a high incidence of lung cancer despite a low smoking prevalence. Associations between exposure to fumes arising from the Chinese style of cooking and female lung cancer have been reported in other areas.

Objective: To examine the association between exposure to cooking fumes and lung cancer risk among women in Hong Kong, taking into consideration the effects of various potential risk factors.

Methods: This study used a case–control design. The cases were Chinese women with newly diagnosed primary lung cancer in a large oncology centre in Hong Kong. Control subjects were randomly sampled from the community using the residential telephone directory, and were frequency matched by 10 year age group. Face to face interviews were conducted using a standardised questionnaire, collecting information on items such as cooking practice, smoking habits, passive smoking, dietary habits, occupational history, previous diseases. Meal year (the number of meals cooked per day multiplied by years of cooking) was calculated to measure cooking fume exposure, and then categorised into quartiles. The odds ratios (OR) for women in the second, third and fourth quartiles of meal year were estimated using women in the first quartile as the reference group. We estimated odds ratios (OR) and 95% confidence intervals (CI) by unconditional logistic regression.

Results: A total of 584 subjects were interviewed, including 252 cases and 332 controls. The proportion of smokers (current or ex-smokers) among cases and controls was 23.0 and 8.7%, respectively. Adenocarcinomas comprised 44.1% of cancers among smokers and 68.9% among nonsmokers. The OR for lung cancer (all subtypes) among exsmokers was 2.5 (95% CI 1.4 to 4.5) and that among current smokers was 4.5 (2.1 to 9.8). Among women in the fourth quartile of mealyear, the OR was 2.4 (1.5 to 3.9). The adjusted OR among these women changed a little, being 2.3 (1.3 to 4.1), after adjusting for other risk factors including smoking, history of diseases, and family history of cancer. No occupational exposure was identified to significantly increase the risk of lung cancer.

Conclusion: The study suggested that Chinese women exposed to cooking fumes may have an increased risk of lung cancer.

O20.5 CANCER MORBIDITY AMONG DANISH SEAMEN: A DANISH POPULATION BASED COHORT STUDY

L. Kaerlev1, J. Hansen2, H. L. Hansen3, P. S. Nielsen1.1Research Unit of Maritime Medicine, University of Southern Denmark, Esbjerg, Denmark; 2Danish Cancer Society, Institute for Epidemiological Cancer Research, Copenhagen, Denmark; Cancer Society, Institute for Epidemiological Cancer Research, Copenhagen, Denmark; 3Embedslgeinstitutionen for Vejle Amt, Vejle, Denmark

Introduction: Seafarers have a high morbidity compared with the background population. Many seafarers sailing on chemical tankers have been exposed to carcinogenic substances such as toxic fumes of benzene, asbestos, chemicals, crude oil, oil products, and exhaust gases.

Objective: To investigate the cancer occurrence among Danish seafarers in relation to type of ship and job title.

Methods: A cohort of all Danish seafarers in the period 1986–99 registered by the Danish Maritime Authority with job history was linked with the Danish Cancer Registry. Type and usage of ship was extracted from ship lists. Potential exposure to chemicals was accessed from the duration of employment on tankers. Standardised incidence rates (SIR) for the studied cancer types were estimated by use of the corresponding national rates.

Results: The overall cancer incidence was higher than expected (SIR 1.25, 95% confidence interval 1.18 to 1.32) mainly due to an excess of cancer of the larynx, lung, mouth, pharynx, stomach, colon, pancreas, kidney, and urinary tract among men. An excess of skin melanomas in both sexes was seen. In particular, men employed on tankers had a high SIR for lung cancer (2.26; 1.59 to 3.11) and a high incidence of testicular cancer. No increased risk of lymphatic or haematopoietic cancers were seen.

Conclusions: Seafarers’ risk of mesotheliomas, lymphatic, and hematopoietic cancers was not statistically significantly increased in the overall analysis. All findings should be regarded as tentative.

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